A challenging case: Blindness and a history of cutaneous nodules in a cat - Veterinary Medicine
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A challenging case: Blindness and a history of cutaneous nodules in a cat
Ocular signs, a decreased appetite, and previous skin nodules were the only clues that this indoor-only cat had a life-threatening disease.


VETERINARY MEDICINE


Public health

Cryptococcosis is not considered a public health threat. The organism cannot spread from one animal to another through contact with tissue or body fluids, and the organism does not aerosolize from infected tissues. Animals can serve as sentinel species for monitoring the disease in a geographic area.2 A hydrated lime solution (40 g/L water) at 1.36 L/m2 can be used to treat the environment, such as areas with a high concentration of pigeon droppings.8

SUMMARY

As the most commonly diagnosed systemic mycosis in cats, cryptococcosis should be considered in the differential diagnoses for any cat with upper respiratory, ocular, dermatologic, or neurologic signs. Definitive diagnosis is best obtained by cytologic or histologic organism identification. Antigen titers are an essential diagnostic test to monitor response to treatment. Treatment with fluconazole or itraconazole is the first choice. Life-threatening cases can be treated with amphotericin B and flucytosine if they fail to respond to a triazole antifungal. Treatment continues for one to two months after clinical signs resolve. Treatment fails more often in patients with ocular and CNS disease.3

Acknowledgment

The authors thank Theresa E. Rizzi, DVM, DACVP, at the Boren Veterinary Medical Teaching Hospital at Oklahoma State University for photographing the fine-needle aspirate microscope slides.

Holly Polf, DVM*
Bissonnet/Southampton Veterinary Clinic
2028 Bissonnet St.
Houston, TX 77005

Michelle Fabiani, DVM, DACVR
Gulf Coast Veterinary Specialists
Diagnostic Imaging
1111 West Loop South
Houston, TX 77027

James F. Swanson, DVM, MS, DACVO
Gulf Coast Animal Eye Clinic
1551 Campbell Road
Houston, TX 77055

*Dr. Polf's current address is Gulf Coast Veterinary Specialists, Diagnostic Imaging, 1111 West Loop South, Houston, TX 77027.

REFERENCES

1. Jacobs GJ, Medleau L. Cryptococcosis. In: Green CE, ed. Infectious diseases of the dog and cat. 2nd ed. Philadelphia, Pa: WB Saunders Co, 1998;383-390.

2. Lester SJ, Kowalewich NJ, Bartlett KH, et al. Clinicopathologic features of an unusual outbreak of cryptococcosis in dogs, cats, ferrets, and a bird: 38 cases (January to July 2003). J Am Vet Med Assoc 2004;225:1716-1722.

3. Ward DA. Oculomycosis. In: Bonagura J, ed. Kirk's current veterinary therapy XII: small animal practice. Philadelphia, Pa: WB Saunders Co, 1995;1257-1261.

4. Legendre AM, Toal RL. Diagnosis and treatment of fungal diseases of the respiratory system. In: Bonagura J, ed. Kirk's current veterinary therapy XIII: small animal practice. Philadelphia, Pa: WB Saunders Co, 2000;815-819.

5. Gerds-Grogan S, Dayreli-Hart B. Feline cryptococcosis: a retrospective evaluation. J Am Anim Hosp Assoc 1997;33:118-122.

6. Sierra P, Guillot J, Jacob H, et al. Fungal flora on cutaneous and mucosal surfaces of cats infected with feline infectious immunodeficiency virus or feline leukemia virus. Am J Vet Res 2000;61:158-161.

7. Taboada J, Grooters AM. Systemic mycoses. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine. 6th ed. St Louis, Mo: Elsevier, 2005;671-690.

8. Lappin MR. Infectious upper respiratory diseases I and II, in Proceedings. West Vet Conf 2003.

9. Jacobs GJ, Medleau L, Calvert C, et al. Cryptococcal infection in cats: factors influencing treatment outcome, and results of sequential serum antigen titers in 35 cats. J Vet Intern Med 1997;11:1-4.

10. Krohne SG. Canine systemic fungal infections. Vet Clin North Am Small Anim Pract 2000;30:1063-1090.


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